Evaluation of the Initial Treatment of Ureteroceles

Objective To assess the results of the initial therapeutic approach to ureteroceles at our institution and the need for further interventions. Patients and Methods This is a retrospective study of all pediatric cases of ureterocele diagnosed at our center between January 2000 and December 2011. Resu...

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Bibliographic Details
Published in:Urology (Ridgewood, N.J.) N.J.), 2016-03, Vol.89, p.113-117
Main Authors: Gander, Romy, Asensio, Marino, Royo, Gloria Fatou, Lloret, Josep
Format: Article
Language:English
Subjects:
Clinical Protocols
Female
Humans
Infant
Male
Retrospective Studies
Treatment Outcome
Ureterocele - therapy
Urology
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Summary:Objective To assess the results of the initial therapeutic approach to ureteroceles at our institution and the need for further interventions. Patients and Methods This is a retrospective study of all pediatric cases of ureterocele diagnosed at our center between January 2000 and December 2011. Results Forty-three patients were analyzed. Initial diagnoses were ureterohydronephrosis in 34 (33 prenatal), febrile urinary tract infection in 5, and prolapsed ureterocele in 3. Expectant management was decided upon in 6 patients (14%). Of these, 1 required surgery. The remaining 37 (86%) initially underwent surgery: transurethral puncture (18), heminephrectomy (14), nephrectomy (3), and reimplantation (2). Twelve (66.6%) of the 18 patients who underwent primary puncture progressed well and required no further intervention. New-onset vesicoureteral reflux to the upper pole appeared after puncture in 3 patients, but none required treatment. Only 6 patients (33.3%) underwent a second procedure. Mean follow-up was 8.5 years (standard deviation: 3.08). Conclusion Early endoscopic puncture is useful for decompression and often the definitive treatment. Although new-onset vesicoureteral reflux into the punctured system is the most common complication, it often resolves spontaneously. Early heminephrectomy in patients with nonfunctioning upper moieties yields excellent results but may not be necessary. Some patients may not need transurethral puncture or any surgical intervention at all.
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2015.11.025